Neuroimaging: subarachnoid haemorrhage: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Neuroimaging: subarachnoid haemorrhage

Sample item

A patient with a thunderclap headache has a normal neurological examination. A non-contrast CT within 6 hours would most likely show which finding?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Hyperdense blood in the basal cisterns and Sylvian fissures

Acute SAH appears as hyperdense blood within the basal cisterns, Sylvian fissures and sulci, and sensitivity of CT within 6 hours approaches 95 to 100 percent. If CT is negative and suspicion persists, lumbar puncture for xanthochromia is performed. CT or catheter angiography then identifies the aneurysm.

Option by option

  • A. Hydrocephalus ex vacuo

    Ex vacuo changes reflect atrophy.

  • B. Periventricular white matter hypodensity

    Periventricular hypodensity suggests chronic small vessel disease or oedema.

  • C. Hyperdense blood in the basal cisterns and Sylvian fissures (correct)

    Correct. Hyperdense blood in the cisterns is typical of acute SAH.

  • D. Ring-enhancing lesion

    A ring-enhancing lesion suggests an abscess or tumour.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is C, Hyperdense blood in the basal cisterns and Sylvian fissures. Acute SAH appears as hyperdense blood within the basal cisterns, Sylvian fissures and sulci, and sensitivity of CT within 6 hours approaches 95 to 100 percent.

Why is "Hydrocephalus ex vacuo" not the answer?

Ex vacuo changes reflect atrophy.

Why is "Periventricular white matter hypodensity" not the answer?

Periventricular hypodensity suggests chronic small vessel disease or oedema.

Why is "Ring-enhancing lesion" not the answer?

A ring-enhancing lesion suggests an abscess or tumour.

What concept does this question test?

It tests Neuroimaging: subarachnoid haemorrhage in Radiology. If CT is negative and suspicion persists, lumbar puncture for xanthochromia is performed. CT or catheter angiography then identifies the aneurysm.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Neuroimaging: subarachnoid haemorrhage?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.